2024 IDA Eligibility Questionnaire

2024 IDA Eligibility Questionnaire

NeighborImpact HomeSource
NeighborImpact is an equal opportunity provider and employer. If you require accommodation, please contact 541-548-2380 or reception@neighborimpact.org. If you are hearing impaired, please dial TYY 711.

Si prefiere una copia en español, llame al 541-548-2380.
Applicant Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County/Territory*

DeschutesCrookJeffersonConfederated Tribes of Warm SpringsOther
Questionnaire
What is your primary savings goal?*

BusinessEducationHome PurchaseVehicle
Did an agency/organization refer you to the IDA program?*

YesNo
Which agency/organization?*
Has anyone in your family ever owned a home in the U.S.? (Family defined as yourself, current partner, parents, grandparents, or grandparents-in-law)*

YesNo
Have you participated in the State Funded Matched Savings (IDA) program before?*

YesNo
When?*
Race and Ethnicity*

African American/BlackAmerican Indian/Alaskan NativeAsianHispanic/LatinoNative Hawaiian/Pacific IslanderWhiteOther

Applicant Information